Bedbugs have become such a hot topic that they’ve sparked Top 10 lists, two to be exact. Two leading pest-control companies, Terminix and Orkin, have published lists of America’s most bedbug-infested cities. And if you live in one of them, you may already know what it’s like to deal with the creepy critters. Or maybe you’re more familiar with the anxiety of wondering whether any of them have found their way into your home. In addition to being stubbornly resistant to the most reliable pest-control methods, they can take a serious emotional and psychological toll.

THE DETAILS: While the two lists disagree about who’s at the top, both feature the same cities—those that see a lot of international travel, including New York, Philadelphia, Chicago, and Los Angeles—and both agree that Ohio has the dubious distinction of being America’s most infested state. (Keep in mind that cities made the lists based on calls to Terminix or Orkin offices in those cities, so a city’s status will be affected by the concentration of a company’s offices there.)

“I do think that these surveys are reflective of cities with major bedbug issues,” says Michael Potter, PhD, extension professor and bedbug expert from the University of Kentucky. “But as a practical matter, it hardly matters if this city or that was ranked 1, 3, 5, 10 or whatever. The problem is indeed getting very serious, and cities that have been relatively spared to this point can expect to deal with more problems in the future.”

WHAT IT MEANS: For most people, the mere thought that their city made the list can trigger anxiety and panic attacks about every little itchy welt that could crop up. And people can get seemingly mixed messages about how serious the problem is. As public-health departments try to get people educated with somewhat alarming messages about what to do if bedbugs infest their homes—”always call an exterminator,” and “the problem is too big to try to handle on your own”—they also continue to reiterate that, aside from leaving behind itchy bites, bedbugs are, for the most part, harmless. No studies have yet shown that they can carry or transmit diseases. Exterminators also feed the problem, says Elaine Rodino, PhD, a psychologist with a private practice in State College, Pennsylvania, who has friends who were affected by bedbugs recently. In their case, she says, “the exterminator was really helpful but also created a lot of further anxiety about how serious this all is,” having the family wash everything they own and toss out some furniture.

The economic trauma can have a severe impact on people, particularly during a recession, says Rodino, so it’s understandable that the bugs inspire panic. But even when a landlord or property manager is available to help foot the bill, people’s anxiety can be overwhelming. “We know for some phobias, both fear and disgust can play a role,” says Bethany Teachman, PhD, associate professor of clinical psychology at University of Virginia. Those are pretty understandable emotions when dealing with bedbugs. But in this case, she adds, there’s the element of the unknown that gets factored in. “People don’t always know where the bedbugs came from, and not much is known about care and management,” she says; when something is that unpredictable and uncontrollable, it can trigger anxiety.

And, of course, there’s the shame and embarrassment. Despite the fact that the bugs are very democratic, afflicting wealthy and poor, neat freak and sloppy Joe alike, people do equate infestations with cleanliness, says Rodino. “Having bedbugs was always seen as something very dirty, and that regular people, so to speak, didn’t get bedbugs,” she says.

Next: How to cope!

Dealing with and getting rid of bedbugs can be traumatic, so here are a few ways to cope, mentally, should you have an infestation:

1. Realize you’re not alone.

“In situations, as with bedbugs, where there does seem to be such an epidemic, people should pull back a bit and realize this is really going on with a lot of people, that it’s a public health issue,” Rodino says. You may be embarrassed to talk about it, but chances are, if you do mention it to a neighbor or friend, you might find a sympathetic ear. And, Rodino adds, you don’t want your shame or embarrassment to keep you from dealing with the problem or calling an exterminator, which can just make the problem worse.

2. Keep your reactions in check.

“You don’t want to eliminate all fear and anxiety,” says Teachman. “After all, fear keeps us safe and motivates us to avoid things that might harm us.” But reactions out of proportion to the trigger can be harmful, she says; for instance, avoiding visits to friends’ and relatives’ homes out of fear that you’ll pass along an infestation, or avoiding all movie theaters because you heard that one movie theater was infested with bedbugs. “It’s easy to lose track of what a reasonable response is,” she adds. “So take a look at what other people are doing.” Talk to friends who’ve dealt with bedbugs before (or find a forum online; sites like BedBugger.com and NewEnglandBedBugForum.org are proliferating nearly as fast as the bugs themselves) and see how others have responded to the problem.

3. Recognize the end is in sight.

As the old saying goes, “this too shall pass.” Having bedbugs is miserable, but “I often reassure people that they’re doing everything in the appropriate way and that there will be a time when they’ll get rid of the bugs,” says Rodino.

I dealt with those little bloodsuckers last year in September, terminated them, havent seen them around here anymore..When the cold weather arrives, I'm gonna open up all the windows for an hour to make sure I wipe out any of those trying to make a hell of a come back! Freeze Damn Little Suckers!

Borax laundry detergent has another use besides cleaning clothes with a nice fresh smell. I had a terrible flea infestation in my home. I had tried literally everything and someone suggested Borax laundry detergent. Borax detergent is a very fine powder. I sprinkled it everywhere on the floors and carpets and vacuumed it up the next day. The fleas were destroyed. Since fleas are a hard critter to exterminate and the Borax detergent was totally effective, I wonder if it would work as well on bed bugs. Wash the bed clothing with it and sprinkle or toss the Borax detergent everywhere and wait 24 hours before vacuuming. It's worth the try. (The Borax detergent also got rid of every roach, spider, etc. that I wasn't aware I had) they were belly up on the floor.